Kansas Medicaid Redetermination – KMAP

February 15, 2023

Please review and pass on this notice regarding Kansas Medicaid Reimbursement

During the Public Health Emergency (PHE), KS Medicaid renewals were placed on hold, meaning that any member that was eligible for Medicaid benefits, remained eligible throughout the COVID pandemic.

Renewals are beginning again and Medicaid members will start to receive communication and renewal packets in the mail. In order for Medicaid recipients to receive this important information, KMAP must have the correct address and phone # on file.

Please communicate the importance of this activity with your Medicaid patients and encourage them to update their address and phone number with KMAP. The attached flyer lists all the ways in which they can accomplish this important task.

CST33492_CAID23_Recert_Provider Flyer_KS_PRNC_2.6.23

Cigna – COVID-19 Public Health Emergency Period to end May 11, 2023

February 14, 2023

Since the COVID-19 pandemic began, we have taken important steps to deliver timely accommodations to providers and customers, helping to ensure that customers have continued access to COVID-19 diagnostic services, testing, and treatment in safe settings.

Ending the public health emergency period

As you are likely aware, the White House recently announced their intent to end both the COVID-19 national emergency and public health emergency (PHE) on May 11, 2023.

As a result, Cigna commercial and Cigna Medicare Advantage intend to extend its cost-share waiver for diagnostic COVID-19 tests and related office visits through at least May 11, 2023, subject to any further announcements or guidance from the administration.

We also continue to evaluate any potential changes to our other ongoing COVID-19 accommodations in preparation for the end of the PHE.

Get all the most up-to-date information

Our dedicated COVID-19 provider web page will be updated in the coming days to highlight the end date of the PHE and to note that we will share additional information soon.

Cigna – Reimbursement policy update: Evaluation and management codes billed with injection administration and testosterone drug codes

February 13, 2023

Cigna – Reimbursement Policy Update – E&M Codes Billed with Injection Admin and Testosterone Drug Codes 041623

  • We will deny evaluation and management (E&M) Current Procedural Terminology (CPT®) codes 99211-99215 billed with CPT code 96372 and Healthcare Common Procedure Coding System (HCPCS) codes J1071 or J3145 by the same provider on the same claim, for the same date of service, and when there are no other services billed on the claim.
  • Only the E&M codes on the claim will be denied.
  • This update is effective for dates of service on or after April 16, 2023.

 

United Healthcare Payer News Updates

February 02, 2023

Please follow the links for detailed updates to the items listed below.  Be sure and share with your staff that would benefit.

Radiation and Oncologic Procedures – Medicare Advantage Coverage Summary (uhcprovider.com)

Reconsideration and appeal submissions going digital | UHCprovider.com

Reconsideration and appeal submissions going digital | UHCprovider.com

Over 600k members to receive new ID cards | UHCprovider.com

Medicare cost-share changes begin Jan. 1, 2023 | UHCprovider.com

Network News | UHCprovider.com

Know more about NexusACO plans | UHCprovider.com

 

Department of Veterans Affairs Community Care Network educational session invite

February 02, 2023

Physicians, Practice Managers, and Staff,

Welcome to the Department of Veterans Affairs Community Care Network (VA CCN). You are invited to attend a Veterans Affairs Community Care Network Overview educational session.

Join us for one of the following virtual one hour educational presentations to learn more about VA CCN, treating Veterans and doing business with VA and Optum.

During this webinar we will discuss:

  • VA CCN Overview
  • Referrals and Appointment Scheduling
  • Providing and Coordinating Care
  • Medical Documentation Requirements and Claims
  • Where to locate additional resources

Registration is required and space is limited. Please register for one of the sessions below by clicking the link for the day you can attend.

Date Microsoft Teams Registration Link
Monday February 6th, 2023

11:00 a.m. CST

Click here to register
Monday February 13th, 2023

11:00 a.m. CST

Click here to register
Monday February 20th, 2023

11:00 a.m. CST

Click here to register
Monday March 6th, 2023

11:00 a.m. CST

Click here to register
Monday March 13th, 2023

11:00 a.m. CST

Click here to register
Monday March 20th, 2023

11:00 a.m. CST

Click here to register

Take advantage of VA CCN Training and Resources

Be sure to check out our new Veterans Affairs Community Care Network (VA CCN) Resources page on Provider Express.

If you have questions regarding this network, please call our VA CCN Provider Services at 1-844-839-6108.

Thank you for supporting our nation’s heroes.

Adam T. Pancake, LPC
Manager – VA CCN Provider Advocacy
Optum Provider Services

Anthem Provider Newsletter – February, 2023

February 01, 2023

Anthem Provider Newsletter – Missouri February 2023

This month’s featured articles

Administrative:

  • Controlling High Blood Pressure and Submitting Compliant Readings
  • AIM Specialty Health will transition to Carelon Medical Benefits Management Inc.
  • Have you reviewed your online provider directory information lately?
  • Do you offer telehealth services? Let us know!

Digital Tools:

  • Enhancing Provider News website and email communications
  • Helping to reduce delays when submitting attachments: Make sure your correspondence includes one of these elements

Medical Policy & Clinical Guidelines:

  • Medical Policies and Clinical Guidelines updates – February 2023
  • AIM Specialty Health Cardiology Clinical Appropriateness Guidelines CPT Code List update
  • Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines

Pharmacy:

  • Specialty pharmacy updates – February 2023

Federal Employee Plan (FEP):

  • 2023 FEP benefit information available online

Medicare:

  • Name change announcement: myNEXUS will transition to Carelon Post Acute Solutions on March 1, 2023
  • Keep up with Medicare News – February 2023

Cigna – Medical coverage policy update – Peripheral Nerve Block Procedures

January 31, 2023

Cigna – Coverage Policy Update – Peripheral Nerve Block Procedures 041623

Cigna routinely reviews their coverage, reimbursement, and administrative
policies for potential updates.  As a result of a recent review, they implement the following medical coverage policy updates.

  • We will deny claims for peripheral nerve block procedures billed with Current Procedural Terminology (CPT®) codes 64505, 64400, and 64405 as experimental, investigational, or unproven (EIU) regardless of the diagnosis.
  • CPT code 64450 will be denied as EIU only when submitted with a headache and/or trigeminal/occipital neuralgia diagnosis.
  • This update is effective for dates of service on or after April 16, 2023.